498 Words About: Bethany, The Ghoul Doctor in Fallout 4
I encountered Bethany when I was roaming the Commonwealth, trying desperately to avoid the locations I knew for a fact would be where they had been on every previous playthrough of the game. I’ve played well over 100 hours Fallout 4, so I've got most key locations on the map memorized. I don’t remember any high school math but I can pinpoint with an alarming degree of accuracy where Walden Pond and Cutler’s Bend are. Thus when replaying the game I purposefully try to look for new sights, new characters, and new secrets that I passed up on previous runs.
That’s how and why I encountered Bethany sleeping in her shack above a bright yellow pond filled with tubs of nuclear waste.
I’m ashamed to admit I thought Bethany was a nurse and not a doctor when I started this essay. I recognise the implied sexism of assuming that a woman living above a small pond of radioactive waste which has turned her into a Ghoul would be a nurse instead of a doctor, and I apologise for it.
Life is about learning from your mistakes, and, more importantly, owning up to them.
Bethany’s small hut does not register on the player’s map as a notable location, and likewise this means players cannot fast travel to her hut the way they can other locations across the commonwealth. She does not provide the player with any side-quests or mini-games, nor does she offer anything in the way of complex dialogue options to uncover greater lore about the region or her history. Bethany acts simply as a merchant providing the player with health items, drugs, occasional bits of junk, and of course the offer of healing.
She’s a doctor you see.
Not a nurse.
Some other dumb-butt thought she was a nurse.
Not me though.
Random non-playable characters (npcs)like Bethany are opportunities to create sub-narratives in open world videogames that foster imagination and build curiosity to explore more of this world. Bethany’s is an NPC that, upon examination, exists largely as an environmental narrative structure.
Fallout 4 is an open-world game which means the player will spend hours just walking about discovering locations and people, and given the radioactive apocalypse nightmare of the world this is fitting. Even 200 years after a nuclear holocaust the Commonwealth still shows signs of the war, how cities imploded, and how lives were destroyed. Bethany is a woman who had a life and a career before the war between the United States and China obliterated everything and resulted in her becoming mutated due to prolonged radiation exposure. Her hut is most likely a former home (hers or someone else's) and she’s clearly trying to find some comfortable existence in the wasteland where raiders, super mutants, malfunctioning robots, and the occasional DeathClaw are waiting to kill anyone at a moment’s notice.
Bethany tells a small small story in Fallout 4’s larger narrative of survival, and she offers me a few stimpacs for the road.
Joshua “Jammer” Smith
7.13.2026
Like what you’re reading? Buy me a coffee & support my Patreon. Please and thank you.